Abstract
We report a case of intramesenteric perforation of obstructive colitis due to rectal cancer with liver metastasis. A73-year-old-man visited our hospital complaining of lower abdominal pain. On physical examination, there was tenderness in his lower abdomen, but without muscular defence. Abdominal computed tomography revealed a liver tumor and an abscess-like tumor along the sigmoid colon. A Gastrographin®-enema showed the applecore sign of the rectum and a leakage of contrast medium at the oral portion of the tumor. An emergency operation was performed 53 hours after the onset of symptoms. A Laparotomy showed rectal cancer with liver metastasis and perforation of the sigmoid colon to the mesocolon. An anterior resection of the rectum together with the sigmoid colon was performed. The resected specimen revealed type 2 carcinoma and a punched-out perforation, 3.0×2.5cm in size, at about 6cm oral from the tumor. Histopathologically, there was normal mucosa about 6cm in length with submucosal edema between the carcinoma and the perforation site.
